北京生物醫(yī)學工程

分叉和狹窄對顱內(nèi)動脈血液流體動力學的影響

Effects of bifurcation and stenosis on hemodynamics of intracranial artery

作者：嚴妤函劉瑜許波郭蕾陳陽希黃方錢曉明萬文輝

單位：東部戰(zhàn)區(qū)總醫(yī)院干部病房一科(南京210002)  東南大學能源與環(huán)境學院(南京210096) 通信作者:萬文輝。E-mial: wanwhnj@sina. com

關(guān)鍵詞：動脈粥樣硬化;顱內(nèi)動脈狹窄;分叉角度;計算流體動力學;剪切力;壓強;速度

分類號：R318. 01

出版年·卷·期（頁碼）：2021·40·6（584-590）

摘要：

目的基于顱內(nèi)動脈數(shù)量眾多且影響因素較多，本文重點研究了分叉角度、對稱分支動脈狹窄度、不對稱分支動脈狹窄度和斑塊尺寸對顱內(nèi)動脈粥樣硬化形成和生長的影響作用，以期利用血流動力學參數(shù)的評估為動脈粥樣硬化的預警、診斷及選擇合適的血管內(nèi)治療等提供一定的指導作用。方法基于計算流體動力學方法，構(gòu)建主支動脈連接分支動脈的幾何模型和有限元模型的邊界條件，設(shè)計 45°-135°區(qū)間共7種分叉角度，依托狹窄度'來表征血管的狹窄程度,通過血液壓力、流速和剪切力等血液流體力學參數(shù)對比分析各因素對顱內(nèi)動脈粥樣硬化的產(chǎn)生及發(fā)展過程的機制。結(jié)果分叉角度對速度比最大值和剪切力最大值基本沒有影響，對壓力最小值影響也較小，最大振幅不超過5%。隨著狹窄度的增加,最小壓力下降而速度比最大值增加，當X從0增加到0. 5、0. 67和0. 75時,最小壓力分別下降了 1. 6 Pa、l. 8 Pa和3. 6 Pa,速度比最大值分別上升了 48%、1. 2倍和1. 9倍;狹窄度對最大剪切力的影響很小,直到當狹窄度增大到0.75時，最大剪切力提升了 5%。非對稱兩個支路狹窄度的比值Q增加時,3個參數(shù)均逐漸增加且增加的幅度隨甲的增加而增大。隨著斑塊長度的增加，壓力最小值呈線性增加，速度比最大值則逐漸增加，剪切力最大值則是逐漸下降,最后趨勢趨于平緩。結(jié)論分叉角度對血液流體力學參數(shù)的影響較小;對稱分支動脈狹窄度越大，或者不對稱分支動脈的狹窄度比值越大，或者斑塊長度越短，均引起血管壁剪切力越大，越容易造成血管內(nèi)壁損傷，加速動脈粥樣硬化。本研究為顱內(nèi)動脈粥樣硬化的形成機制、影響因素以及預測轉(zhuǎn)歸等方面提供有用信息。

Objective Based on the numerous numbers of intracranial artery and more influencing factors, this paper focused on the influence of bifurcation angle, stenosis degree of symmetric branch artery, stenosis degree of asymmetric branch artery and plaque size on the formation and growth of intracranial atherosclerosis, providing a certain guiding role for early warning, diagnosis and selection of appropriate endovascular treatment for atherosclerosis by evaluation of hemodynamic parameters. Methods Based on the computational fluid dynamics method, the geometric model of connection between main and branch arteries and the boundary conditions of finite element model are constructed. A total of seven bifurcation angles are designed among 45° and 135° ,and the stenosis degree is characterized by X. The formation and development mechanism of intracranial atherosclerosis induced by various factors are analyzed by comparing the hemodynamic parameters such as blood pressure, flow rate and shear force. Results The bifurcation angle has little effect on the maximum velocity ratio and maximum shear force, but little effect on the minimum pressure with maximum amplitude of less than 5%. When X increases from 0 to 0. 5,0. 67 and 0. 75, the minimum pressure decreases by 1. 6 Pa, 1. 8 Pa and 3. 6 Pa, and the maximum velocity ratio increases by 48%, 1. 2 times and 1. 9 times,respectively. The effect of stenosis degree on maximum shear force is small, while the maximum shear force increases 5% in the stenosis degree of 0. 75 than that of 0. With the increase of ratio of two asymmetric branches narrowness (<p) ,all three parameters gradually increase. In addition, the larger <p leads greater increase amplitude. With the increase of patch length, the minimum value of pressure increases linearly, the maximum velocity ratio gradually increases and then tends to be flat, and the maximum value of shear force gradually decreases and then also tends to be flat. Conclusions The present study shows that the bifurcation angle has little effect on the hemodynamic parameters. The greater stenosis degree of symmetric branch artery and the ratio of stenosis degree of asymmetric branch artery, or the shorter plaque length cause larger haemal wall shear stress, which is more likely to cause the damage of blood vessels and accelerate atherosclerosis. This paper provides useful information for formation mechanism, influencing factors and predicting outcome of intracranial atherosclerosis.

參考文獻：

[ ]劉有軍，刁越，高松.血流動力學與動脈粥樣硬化(一)[J]. 北京生物醫(yī)學工程,2004,23(4) ；293-295.

[2]邱曉寧，費智敏，張玨，等.壁面彈性對分叉頸動脈個體化病例血流動力學影響的數(shù)值模擬[J].上海交通大學學報(醫(yī)學版),2011,31(11) ： 1554-1559.

Qiu XN, Fei ZM, Zhang J, et al. Numerical simulation of influence of wall elasticity of patient-specific carotid bifurcation on hemodynamics [ J]. Journal of Shanghai Jiaotong University (Medical Science) ,2011,31(11) ： 1554-1559.

[3]鹿曄,張樹生.基于CFD的血管病變部位血流流變特性分析 [JL東北大學學報(自然科學版),2020,41(1):148-152.

Lu Y, Zhang SS. Rheological characteristics analysis of blood flow at the site of vascular lesion based on CFD [ J ]. Journal of Northeastern University ( Natural Science ) , 2020 , 41 ( 1 )； 148-152.

[4 ] Lopes D, Puga H, Teixeira J, et al. Blood flow simulations in patient-specific geometries of the carotid artery； a systematic review [ J] . Journal of Biomechanics,2020,111 : 110019.

[5] Mendieta JB, Fontanarosa D, Wang JQ, et al. The importance of blood rheology in patient-specific computational fluid dynamics simulation of stenotic carotid arteries [ J ]. Biomechanics and Modeling in Mechanobiology,2020,19 ： 1477—1490.

[6 ]王彥鵬.復雜形狀血管中血液兩相流動研究[D].西安:西北工業(yè)大學,2007.

[7]王練妹，胡繼文,雷衛(wèi)瑞，等.關(guān)于動脈粥樣硬化斑塊有缺陷時的力學應(yīng)力分析[J].安徽師范大學學報(自然科學版)， 2019,42(6) ：538-543.

Wang LM,Hu JW, Lei WR, et al. Mechanical stress analysis of defects in atherosclerotic plaque [ J ]. Journal of Anhui Normal University (Natural Science) ,2019,42(6) ：538-543.

[8]馬燕山，高潔，謝英花，等.管壁切應(yīng)力在冠狀動脈粥樣硬化中的重要作用:狹窄冠狀動脈的有限元研究[〕].中國動脈硬化雜志,2018,26(8) ：831-835.

Ma YS,Gao J, Xie YH, et al. The important role of wall shear stress in coronary atherosclerosis: finite element study of stenosis coronary artery[ J] . Chinese Journal of Arteriosclerosis,2018,26 (8) ：831-835.

[9] Piemjaiswang R, Ding Y, Feng YQ, et al. Effect of transport parameters on atherosclerotic lesion growth: a parameter sensitivity analysis [ J]. Computer Methods and Programs in Biomedicine, 2021,199：105904.

[10]?蘇艷平，康秀英.格子Boltzmann方法模擬狹窄頸動脈修復前后的流場口]?北京師范大學學報(自然科學版),2012,48 (1) ：24-28.

Su YP, Kang XY. Lattice Boltzmann simulation of blood flow in carotid artery before and after stenoses [ J]. Journal of Beijing Normal University (Natural Science) ,2012,48( 1) ：24-28.

[11]?張毅卓，葛森，王良軍，等.基于格子Boltzmann方法和大渦模擬的頸動脈分叉狹窄流動并行計算[J].計算機應(yīng)用,2020, 40(2) ：404-409.

Zhang YZ, Ge S, Wang LJ, et al. Parallel computing of bifurcation stenosis flows of carotid artery based on lattice Boltzmann method and large eddy simulation model [ J ]. Journal of Computer Applications,2020,40(2) .404-409,

[12]?謝艷輝.不同程度冠狀動脈狹窄對血管血流動力學的影響及其血流動力學風險評估[D].鄭州:鄭州大學,2018.

Xie YH. Effect of diflferent coronary artery stenosis on the hemodynamics and evaluation of hemodynamic risk factors of coronary artery stenosis [ D ]. Zhengzhou: Zhengzhou University, 2018.

[13]?丁金立，王海闊,馬國鋒，等.個性化顱內(nèi)動脈瘤患者腦動脈血管三維容積重建及其應(yīng)用[J].北京生物醫(yī)學工程,2020, 39(2) ：117-122,151.

Ding JL, Wang HK, Ma GF, et al. Three-dimensional volume reconstruction of cerebral arteries for an individual patient with intracranial aneurysm and its application[ J] . Beijing Biomedical Engineering,2020,39(2) ： 117-122,151.

[14]?張洪軍.讀懂腔梗，科學應(yīng)對[J].疾病防治,2019(11):21.

[15]?周存河，崔彩霞,崔慧先，等.動脈分叉角度與腦動脈瘤的相關(guān)性[J].山西醫(yī)科大學學報,2015,46(7) ：654-657.

Zhou CH, Cui CX, Cui HX, et al. Correlation between artery bifurcation angle and cerebral aneurysm [ J ]. Journal of Shanxi Medical University ,2015,46(7) ： 654-657.

[16] 王楠楠，馮繼玲，王義亮.冠狀動脈分叉角度對血液流體力學及斑塊形成分布的影響[J].生物醫(yī)學工程研究,2018,37 (3) ：291-296.Wang NN, Feng JL, Wang YL. The effect of left coronary bifurcation angle on vascular fluid hemodynamics as well as [20] plaque formation and distribution [ J ]. Journal of Biomedical Engineering Research ,2018,37(3) ： 291 -296,

[17]?來文洋.基于CFD的頸動脈粥樣硬化血流動力學研究及影響因素分析[D].濟南:山東大學,2016：22.

Lai WY. Hemodynamic study of carotid artery atherosclerosis and its influencing factors based on CFD [ D ]. Jinan: Shandong University ,2016： 22.

[18]?尤瑩,狹窄動脈及血液脈動流的數(shù)值模擬研究[D].西安:西北工業(yè)大學,2007：42. You Y. Numerical simulation of stenosed arteries and pulsating blood flow [ D ]. Xi * an ： Northwestern Polytechnical University, 2007：42.

[19] Gorelick PB, Wong KS, Bae HJ, et al. Large artery intracranial occlusive disease: a large worldwide burden but a relatively?neglected frontier [J]. Stroke, 2008,39(8) : 2396-2399.?

[20] 張華，倪旳，王思靜，等.動脈粥樣硬化的發(fā)生機制和中醫(yī)藥干預研究進展[J].中醫(yī)結(jié)合心腦血管病雜志，2019,17(21)： 3342-3347.

[21] 喬紅艷，張龍江.基于影像的計算流體力學在冠狀動脈疾病中的研究進展[J].國際醫(yī)學放射學雜志,2019,42 (6)： 678-683.

Qiao HY, Zhang LJ. Research progress of image-based computational fluid dynamics in coronary artery diseases [ J ]. International Journal of Medical Radiology, 2019, 42 ( 6 )： 678-683.

[22] Li ZY, Howarth SPS, Tang T, et al. How critical is fibrous cap thickness to carotid plaque stability? A flow-plaque interaction model：J], Stroke,2006,37(5):1195-1199.

服務(wù)與反饋：

【文章下載】【加入收藏】

提示：您還未登錄，請登錄！點此登錄

51黑料吃瓜在线观看,51黑料官网|51黑料捷克街头搭讪_51黑料入口最新视频